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Acurus
Manager_TransitionAcurus • Chennai, India
Manager_Transition

Manager_Transition

Acurus • Chennai, India
7 days ago
Job description
About the Role

We are seeking an experienced RCM Manager to lead our Professional (CMS-1500) Billing operations across multiple specialties. This role owns end-to-end billing delivery for existing client accounts, drives new client/project implementations, and oversees EDI and ERA enrollment functions. The ideal candidate combines strong operational management skills with deep subject-matter expertise in US healthcare provider billing, and has a track record of leading teams through client transitions and go-lives.

Key Responsibilities

Operations & Team Management

  • Manage day-to-day operations of the professional billing team across multiple specialties and client accounts
  • Set, monitor, and drive team performance against KPIs: clean claim rate, days in AR, denial rate, productivity, and quality/accuracy targets
  • Conduct regular huddles, one-on-ones, and performance reviews; manage coaching, training, and PIPs as needed
  • Own workforce planning, shift scheduling, and capacity/utilization management
  • Build and maintain SOPs, training materials, and quality audit frameworks for the billing function
  • Escalation point for complex claims, payer issues, and client escalations

New Project / Client Implementation

  • Lead billing workstreams for new client onboarding and transitions, from kickoff through go-live and stabilization
  • Partner with Implementation, Credentialing, IT, and Coding teams to define timelines, dependencies, and readiness criteria
  • Oversee PM/EHR system configuration validation, charge master setup, and fee schedule mapping relevant to billing
  • Drive parallel billing runs, UAT, and go/no-go decisions for new accounts
  • Identify workflow gaps and implement process improvements during and after transition
  • Present implementation status, risks, and readiness updates to internal leadership and client stakeholders

EDI & ERA Enrollment Oversight

  • Own the EDI enrollment function across payers and clearinghouses, ensuring timely completion and tracking
  • Oversee ERA (835) / EFT enrollment processes, ensuring accurate payer setup for electronic payment posting
  • Manage relationships and escalations with clearinghouse partners (e.g., Availity, Waystar, Change Healthcare, Office Ally, Trizetto)
  • Review and approve enrollment trackers; ensure SLAs for enrollment turnaround are met
  • Troubleshoot systemic EDI/ERA issues impacting claim transmission or payment posting across accounts

Reporting & Stakeholder Management

  • Prepare and present operational dashboards and MBRs/QBRs to internal leadership and clients
  • Analyze denial trends, AR aging, and root causes; drive corrective action plans
  • Ensure compliance with HIPAA, payer regulations, and internal quality standards
  • Act as primary liaison between the billing team, client stakeholders, and internal support functions (Credentialing, Coding, IT, AR/Denials)

Required Qualifications

  • [8+] years of experience in US Healthcare Professional (Physician) Billing / RCM, with at least 3+ years in a supervisory or management role
  • Demonstrated experience managing multi-specialty billing operations
  • Proven experience leading new client/project implementations or transitions in an RCM environment
  • Strong working knowledge of EDI, ERA, and EFT enrollment processes with payers and clearinghouses
  • Solid understanding of the full RCM cycle: charge entry, claims submission, denial management, AR follow-up, payment posting
  • Experience with practice management/EHR systems NextGen, Officeally and E-Clinical Works
  • Strong knowledge of payer-specific billing guidelines (Medicare, Medicaid, Commercial, Workers' Comp)
  • Proven ability to manage teams of [15+] FTEs in a production/BPO environment
  • Strong Excel/reporting skills; experience with dashboards (Power BI, Tableau, or similar) is a plus

Preferred Qualifications

  • Experience managing multiple clearinghouse relationships and enrollment escalations
  • Prior experience in a BPO/KPO environment supporting US healthcare clients
  • Exposure to Six Sigma/Lean process improvement methodologies

Skills

  • Strong leadership, coaching, and people-management skills
  • Excellent client-facing communication and presentation skills
  • Analytical mindset with strong problem-solving and decision-making abilities
  • Ability to manage multiple accounts, specialties, and implementations concurrently
  • High attention to detail with a strong compliance and quality orientation (HIPAA)
  • Comfortable operating in a fast-paced, deadline-driven environment

Skills Required
Power Bi, Edi, Excel Reporting, Rcm, nextgen, Tableau
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Manager_Transition • Chennai, India

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